First Reported Ivor Lewis Esophagectomy Using the HUGO RAS System in a High-Volume Center: A Technical Feasibility...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robot-assisted minimally invasive esophagectomy (RAMIE) is growing for esophageal cancer treatment.
• High costs and limited platform availability hinder widespread robotic system adoption.
• The HUGO RAS system is a new modular platform with limited data in esophageal surgery.

Purpose of the Study:

• To describe the technical implementation and workflow of robot-assisted Ivor Lewis esophagectomy using the HUGO RAS system.
• To illustrate the integration of the HUGO RAS system in a complex two-cavity procedure.

Main Methods:

• Standardized two-stage (abdominal and thoracic) robot-assisted Ivor Lewis esophagectomy using the HUGO RAS system.
• Detailed port placement, docking, arm positioning, and instrument management.
• Focus on esophageal mobilization, lymphadenectomy, and intrathoracic anastomosis.

Main Results:

• Successful completion without intraoperative complications or conversion.
• Achieved oncologic resection with negative margins (R0) and 23 lymph nodes harvested (ypT3 ypN2).
• Postoperative course included managed atrial arrhythmia and pneumonia; no anastomotic complications occurred.

Conclusions:

• Robot-assisted Ivor Lewis esophagectomy is feasible with the HUGO RAS system.
• The modular design supports flexible docking and a safe workflow for complex procedures.
• Findings may encourage broader adoption of this robotic platform in upper gastrointestinal surgery.